Slow Steady Progress
Today started pretty early. A steady stream of doctors and nurses came in regularly through the night - checking vitals, adjusting meds, inspecting surgical areas, and discussing whether things were getting worse or getting better. A pattern emerged that would persist through the day: the STICU doctors and nurses were seeing signs of stability and progress, but the plastic surgery team wasn't satisfied. Kate was still needing oxygen and blood pressure meds but at a steady rate, not increasing. She wasn't getting a lot better, but she wasn't getting worse either. The plastic surgery team, who has the final say on course of treatment, wanted to see more progress than they were seeing. They were concerned that ongoing dependency on meds for blood pressure could mean persistent infection hiding somewhere that could come roaring back at any moment. So they came in frequently to inspect the wounds, take pictures, compare to previous pictures, and discuss among their team whether things were getting better or worse. The consensus was - about the same, maybe a little better. Which has been the theme of the day.
As we come to the end of the day (shift change is happening as I write this), we can look back and see slow steady progress. Kate is on lower doses of blood pressure meds than when she started the day, and her BP is staying strong. She's also on less oxygen and her SPO2 is staying high. These are all good signs. Unfortunately the plastic surgery team is still not satisfied. There was a miscommunication earlier with an ICU physician who said it should be fine for Kate to eat dinner (she hasn't eaten all day), but the plastic surgery team came in - while she was eating - and overruled, saying she shouldn't be eating. After some discussion they relented and agreed to allow clear liquids, but that obviously felt like a disappointment after getting in a few bites of Mediterranean takeout in!!
Through it all Kate has felt pretty good and has maintained good spirits, texting updates to friends and family through the day. Ethan came out and we watched some soccer and college football together which provided a nice distraction. She was also able to rest in the small windows of time she wasn't being poked, prodded, and examined. She was also able to do some walks around the floor through the day and was very stable and able to do so without much pain.
Throughout Kate's cancer journey we've had our share of frustration with the healthcare system - the lack of communication and coordination among teams, the rotating cast of doctors, residents, and attending physicians that go with a teaching hospital, the disjointed nature of care that often puts the pressure of maintaining the thread of care on patients and families, and more. But we've been so grateful for the individual caregivers - particularly our nurses. The nurses here on the STICU have been so helpful and really been an advocate for Kate's care through the rotating cast of characters the plastic surgery team has rolled through. One fun "small world" moment was our day nurse Addie said she thought she knew me from somewhere. Turns out she and her husband have been attending our church off an on the last several months! She was really wonderful and brought such a great cheerful attitude to her work. It felt like another gift of grace among the difficulties.
We are also grateful for the texts and calls from all of you. You've been so kind to send us your love and prayers along with offers for help. We're not sure how long we'll be here in the hospital - probably a couple more days - but for now we have all we need. Just keep the prayers coming!